Who We Are:Only Pediatric Office in Watauga and Avery Countyserve Ashe, Avery, Caldwell, Watauga and Tennessee5 Physicians, 4 Physician Assistants, 1 Pediatric Nurse PractitionerVaccine RatesChildren Who Are Behind On Vaccinestemperature logsemployee educationI am in My Vaccine zoneNumber of Patients in Our PracticeMedicaid: 5900 Self Pay: 225 Private insurance: 6757 Total number of patients: 12,882Number of Employees:WHY DID WE START WORKING ON OUR VACCINATION RATES? SITE VISIT: Reports during the site visit showed that our Vaccination Coverage rates were low for ALL age groups especially 24-36 months of age. Amanda's Vaccine Zone:inventory (FOR MAIN OFFICE AND AVERY OFFICE)ordering FOR MAIN OFFICE AND AVERY OFFICE(STATE, PRIVATE-MERCK, SANOFI, GSK, MEDIMMUNE, PFIZER)running benchmark reportsmailing out postcardsplanning and coordinating Flu Clinicsentering demographic information into the NCIR.anything vaccine relatedThe Zone just reminds my coworkers and physicians don't disturb me during this time. I get 1.5 day to work on vaccines the other times I am with a physician. We started working on coverage ratesin 2011. We also looked at adolescents and upcoming sixth graders. Rates are a continuous job! We have continued to check vaccine rates for all age groupsHOW DID WE BEGIN TO INCREASE OUR RATES:Team- (Clinical Coworkers) explained how the rates looked, what we could do to increase those rates- each team member received a page of the benchmark report (in down time the team and myself would work on the reportsComparison of EMR and NCIR-Transferred all Historical information from EMR to NCIREntered demographic information into the NCIR (BRP designed the information sheet to reflect the necessary information needed for the NCIR)HOW DID WE BEGIN TO INCREASE OUR RATESDuring the review of our charts if a patient had not received a checkup we would recommend a checkup or a Nurse Appointment to get vaccines caught up. We contacted patients through postcards that our office had designed.If patients had moved from our practice, then we Inactive on NCIR & EMR.Reviewed the NC Carolina Access Provider Enrollment Report- for those that had Medicaid who had not been seen I compared this list to see if we were still the patient's provider as well as an updated address to contact the parents. WHAT DID THE PRACTICE DO TO HELP INCREASE THE RATESPhysicians & Extenders started recommending vaccines more, ordering more especially if patients were behind and had not had been in the office for checkupsNursing Staff, logs into the NCIR on their laptops-while working up patients will review what vaccines are in the EMR/NCIR and then what the NCIR states patient needs or is recommended-the nursing staff will go ahead and order these vaccines in the EMR and during the checkup physicians will discuss these, physicians are responsible for taking out what is not orderedRefusals- enter all refusals in the NCIR under the Client CommentsDisease of Varicella or Titers enter under the Client Comments

Historical information was not entered especially their MMR, Varicella, Hep BDemographic information was not entered.Adolescents had their 1st dose of HPV but we didn't track if they ever came back for their 2nd dose of HPVWHAT OTHER AGES HAVE WE LOOKED AT?2MONTHS-12 MONTHS OF AGE:REPORT RAN ON 03/25/2013: 51 % MET ALL BENCHMARK CRITERIA60% WAS LATE UP-TO-DATE